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					                          SIMPLIFIED REQUEST FOR PROPOSALS
                   Agency of Human Services, Department for Children and Families

Title: Medical Consultant Services for Disability Determination
Date: January 10, 2011
Requisition Number: (Filled in By Business Office)
1   BACKGROUND AND SCOPE: The Vermont Department for Children and Families, Disability
    Determination Services, is seeking to establish service agreements with one (or more) physicians and/or
    psychologists that can provide Medical Consultant Services for Disability Determination Services located at 93
    Pilgrim Park Road, Suite 6, Waterbury, VT 05676.

    Required Qualifications

     ♦ Licensure – current, unrestricted Vermont licensure as doctor of medicine, osteopathy, or psychology; those
       with medical or osteopathic licensure must be board certified or eligible in their specialty.
     ♦ Availability – ability to provide consultative services at least eight (8) hours per week at the Disability
       Determination Services office in Waterbury, VT. Since interaction between the consultant and lay
       adjudicators is frequently required in the case assessment process, services must generally be performed
       between 6:00 AM and 6:00 PM Monday through Friday in the Waterbury office.
     ♦ Basic computer skills –required for such activities as
         Reading electronic files with administrative forms, application data, and medical evidence
         Completing electronic forms and typing narrative text to explain your assessment
         Navigating using Microsoft Windows
         Researching internet medical texts and program policy resources
         Sending and reading email communications
     ♦ Prior to contract execution, selected candidates must pass any level of background investigation applicable
        to the position. AHS Policy 4.02, Hiring Standards, pursuant to 20 V.S.A. 2056c or other applicable
        statutory authority, requires criminal record checks for all AHS positions, including motor vehicle driving
        record checks and national record checks where appropriate.

    Preferred Qualifications

    Preferred disciplines include Internal Medicine, Family Practice, Primary Care, Osteopathy, Physiatry,
    Pulmonology, Cardiology, Pediatrics, Psychiatry and Doctoral Level Psychology. Preferred candidates will have
    at least 3-5 years postdoctoral experience. Further preference will be given to experience working within an
    interdisciplinary team and to knowledge of the Social Security Disability program or other disability eligibility
    programs, although these are not required.

    Introduction

    The purpose of this Request for Proposal is to obtain the services of medical professionals in assessing the
    medical eligibility of Vermont applicants for Social Security Disability Insurance, Supplemental Security Income,
    and/or Medicaid on the basis of disability. These consultant services include oral and written consultations and
    assessments of impairment severity and residual functional capacity based on reviews of disability case files and
    application of Social Security disability program policy. No patient contact is involved. Basic computer
    proficiency is necessary to read electronic case files, complete forms, type assessments, and correspond via email
    with lay adjudicators. There is some required telephone contact with healthcare providers to clarify their reports
    and opinions. Medical consultants perform their work at the Disability Determination Services office, under the
    direction of DDS personnel. The hourly rate of compensation is according to the established fee schedule
                                                    Page 1 of 21
                      SIMPLIFIED REQUEST FOR PROPOSALS
              Agency of Human Services, Department for Children and Families
(below); contractors are not eligible for additional state benefits. Disability Determination Services is looking for
approximately 50 hours total of somatic medical consultant services per week, and up to 12 hours of psychiatric
or psychological consultant services per week. The selection will be made by 1) ranking candidates on
qualifications and experience through review of the submitted documents and a panel interview; and 2)
determining the number of contracts to award based on the availability (number of hours per week) that the
top-ranking candidates offer.

Brief Description of Disability Determination Services

Disability Determination Services is an office within the Department for Children and Families in the Agency of
Human Services. Under the Social Security Act, this office has statutory authority to make determinations of
disability for the Social Security Administration‟s disability programs. In Vermont, it also determines disability
for eligibility for Medicaid, under Title XIX of the Social Security Act. Disability Determination Services must
follow all federal statutes, rulings, regulations and policy related to these programs. Its work is subject to quality
review by Social Security and must meet regulatory performance requirements. It is fully federally funded with a
budget of approximately $4.29 million per year. It processes approximately 7000 disability claims and reviews
per year with a staff of 32 state employees and 10-14 contract medical consultants. Its mission is to provide
applicants with accurate decisions as quickly as possible with full and fair consideration of each applicant‟s
situation and with respect and concern for the individual‟s well-being and legal rights.

Statement of Work to Be Performed

The contractor shall provide medical consultant services to Disability Determination Services as follows:

 a. Review and interpret medical evidence in written and electronic formats in connection with adjudicating
    disability claims.
 b. Provide assessments, in written and electronic format, of abilities and inabilities of disability applicants.
 c. Recommend needed medical development of disability claims.
 d. Consult with adjudicators, supervisors and other medical staff on medical issues involved in adjudicating
    claims.
 e. Review and sign completed disability determinations.
 f. Contact medical sources submitting evidence of record or consultative examinations to clarify report
    information or obtain further information needed in connection with claim adjudication.
 g. Review completed claim adjudications for compliance with program medical and evidential requirements,
    if requested.
 h. Give evidence at hearings in connection with contested denials of claims for disability benefits, if
    requested.
 i.   Attend scheduled training and information meetings with other agency staff and Social Security
      Administration personnel, if requested.
 j.   Perform the above listed duties on a regularly scheduled basis acceptable to the State and modifiable with
      the approval of the State.
 k. Perform the above listed duties with legal accuracy in the most cost-effective and efficient manner possible
    under the direction of the State.


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                     SIMPLIFIED REQUEST FOR PROPOSALS
             Agency of Human Services, Department for Children and Families
l.   Perform related duties as required which may include instructional training of staff and/or other medical
     consultants.
m. Maintain a valid, unrestricted license to practice medicine, osteopathy, or doctoral-level psychology in
   Vermont, uninterrupted for the entire term of the contract. Provide copy to Disability Determination
   Services at the start of the contract and with each licensure renewal during the life of the contract.
n. Principal location for providing services will be the office of the State Disability Determination Services
   located in Pilgrim Park, Waterbury, Vermont.
o. The Bidder must adhere to confidentiality requirements under the federal Privacy Act, the Health
   Insurance Portability and Accountability Act (HIPAA), Social Security regulations, and the Agency of
   Human Services Rule # 96-23 concerning access to information. Bidders must also recuse themselves
   from involvement in any claim in which they have prior knowledge or experience outside Disability
   Determination Services.
Performance Expectations

Medical consultants at Disability Determination Services are contract employees who receive programmatic
training and whose work is overseen by the Director and Chief Medical Consultant, with ongoing input from
lay adjudicators and supervisors.

New medical consultants receive training from Disability Determination personnel in the Social Security
Disability Program, its laws, regulations, rulings and policies, as these apply to evidentiary documentation
requirements and evaluation of medical eligibility. This includes analysis of impairment severity, duration, and
functional capacities from the case record. Consultants learn to apply this training to individual cases through a
process of mentoring and feedback provided by the Chief Medical Consultant and an experienced adjudicator
until the contractor has demonstrated independent competence in providing legally accurate case assessments
at a reasonable productivity level.

The consultant‟s case assessment quality continues to be monitored by the Chief Medical Consultant with
input from senior adjudicators and supervisors. Social Security performs quality reviews of statistical samples
of disability determinations, and the medical consultants are accountable for any significant
medical/programmatic errors found in their case assessments. The Disability Determination Director monitors
consultants‟ overall performance according to the following expectations:
    ♦ Decisional accuracy of 96% or better
    ♦ Productivity of 30-60 average minutes per case, depending on case length and complexity
    ♦ Regular attendance at the negotiated number of hours per week
The Contractor must adhere to confidentiality requirements under the federal Privacy Act, the Health
Insurance Portability and Accountability Act (HIPAA), and the Agency of Human Services Rule # 96-23
concerning access to information. Contractors must also recuse themselves from involvement in any claim in
which they have prior knowledge or experience outside Disability Determination Services.

Either party may cancel the contract for any reason by giving written notice at least 30 days in advance. The
Disability Determination Services Director may cancel the contract of any medical consultant who does not
perform at the required level of accuracy, productivity, and attendance, after sufficient training, mentoring, and
performance feedback. However, notwithstanding the foregoing, if the Contractor's work is deficient in a way
that poses immediate jeopardy to claimants‟ health, welfare and safety, the State may terminate this Contract
immediately, and shall give such notice of effective date of termination, as the State in its sole discretion shall
deem appropriate. Loss of license may be grounds for immediate cancellation, and the Contractor is required
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                             SIMPLIFIED REQUEST FOR PROPOSALS
                   Agency of Human Services, Department for Children and Families
     to notify the State if there is a loss of license, or if the licensed status is is being investigated, restricted, or on
     suspension.

     Fee Schedule

     Medical consultant contractors will receive compensation per hour of service according to the rates in the
     chart below. The State of Vermont additionally provides FICA employer contributions and performs wage
     withholding for tax and FICA purposes. The State of Vermont carries professional liability coverage for
     contractual Disability Determination medical consultants. No other state benefits are included.

                           Contract Years*                      Hourly Rate

                1st Year                                           $50.00

                2nd through 5th Years                              $55.00

                6th Year on                                        $60.00

                Chief Medical Consultants                     Above + $10.00


     * To complete a “contract year”, the medical consultant‟s work schedule must be at least 15 hours per week.
        For medical consultants whose work schedules are less than 15 hours per week:
         Year 2 will begin upon completion of 780 hrs (the equivalent of 1 year at 15 hours per week)
         Year 6 will occur upon completion of 3900 hrs (the equivalent of 5 years at 15 hours per week)


2   CONTRACT PERIOD: Contract(s) arising from this request for proposal will be for a period of 18 months
    with an option to renew for additional 12-month period. Proposed start date will be April 4, 2011.
3   SINGLE POINT OF CONTACT: All communications concerning this Request For Proposal (RFP) are to
    be addressed in writing to the attention of: Trudy Lyon-Hart, Director, Disability Determination Services, 93
    Pilgrim Park Road, Suite 6, Waterbury, VT 05676, (802) 241-2464 or trudy.lyon-hart@ssa.gov. Trudy Lyon-
    Hart will be the sole contact for this proposal. Attempts by bidders to contact any other party could result in
    the rejection of their proposal.
4   COSTS OF PREPARATION: The bidder shall be solely responsible for all expenses incurred in the
    preparation of a response to this RFP and shall be responsible for all expenses associated with any presentation
    or demonstrations associated with this request and or proposals made. The bidder shall also be solely
    responsible for the cost preparing responses to scope of work requests submitted by departments over the
    course of the contract.
5    REJECTION RIGHTS
    DCF may, at any time and at its sole discretion and without penalty, reject any and all proposals in any
    „catchment‟ area and issue no contract in that area as a result of this RFP. Furthermore, a proposal may
    be rejected for one or more of the following reasons or for any other reason deemed to be in the best
    interest of the State:
       5.11.1 The failure of the bidder to adhere to one or more provisions established in this RFP.
       5.11.2 The failure of the bidder to submit required information in the format specified in this RFP.
       5.11.3 The failure of the bidder to adhere to generally accepted ethical and professional principles during
              the RFP process.
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                          SIMPLIFIED REQUEST FOR PROPOSALS
                  Agency of Human Services, Department for Children and Families
6   PUBLIC RECORD DISCLOSURE:
       6.11.1 All proposals shall become the property of the State.
       6.11.2 All public records of DCF are available for disclosure, except for RFPs prior to the release to
              potential bidders; and proposals and bids received in response to the RFP, until the Contractor and
              DCF have executed the contract. At that time, the unsuccessful bidders may request a copy of their
              own score sheets as well as request to view the successful bidder‟s proposal at DCF Central Office.
       6.11.3 DCF will not disclose RFP records until execution of the contract(s). At that time, all information
              about the competitive procurement is disclosed except those portions specifically marked by the
              bidder as falling within one of the exceptions of 1, V.S.A., Ch. 5 Sec. 317.
7   AUTHORITY TO BIND DCF: The Commissioner and Deputy Commissioner of DCF (in parent AHS
    Secretary or Deputy Secretary) are the only persons who may legally commit DCF to any contract agreements.
    The Contractor shall not incur, and DCF shall not pay, any costs incurred before a contract is fully executed.
8   PROPOSAL REVIEW: Each of the proposals will have a Review Team of knowledgeable individuals to
    evaluate proposals. The team members will be from the Office of Disability Determination Services and/or the
    central office of DCF. The Disability Determination Services management team shall review all proposals for
    compliance with RFP procedural instructions and the required qualifications. If the procedural instructions are
    not followed, the proposal shall be considered non-responsive. Non-responsive proposals will be eliminated
    from further evaluation. The Review Team will then conduct a structured interview of the responsive and
    qualified candidates.
9   DELIVERY OF PROPOSALS: Your proposal, (all components including hard copies AND e-mail
    and/or CD copy) whether mailed or hand delivered, must arrive at the Disability Determination Services no
    later than 3:00 PM, February 11, 2011. Mailed proposals must be addressed as follows:
       ATTN: Trudy Lyon-Hart, Director
       Sealed Bid – Do Not Open in the Mailroom
       Disability Determination Services
       93 Pilgrim Park Road, Suite 6
       Waterbury, VT 05676
    Late responses shall not be accepted and shall automatically be disqualified from further consideration.
    The method of delivery shall be at your discretion, and shall be at your sole risk to assure delivery at the
    designated office. DCF does not take responsibility for any problems in mail or delivery, either within
    or outside DCF. Receipt by any other office or mailroom is not equivalent to receipt by DCF.
10 SCORING: For each proposal, the three sections outlined in this section (Letter of Interest, Bidders
   Experience, and Bidders Qualifications/Skills) must be addressed in your proposal and at the interview.
   Following interviews of the responsive and qualified candidates, candidates will be scored by individual Review
   Team members. Scoring is intended to clarify strengths and weaknesses of candidates relative to one another
   and to provide guidance to decision-makers. The sum of the scores of the members will become the proposal‟s
   final score. (see criteria for scoring on the following pages).




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                               SIMPLIFIED REQUEST FOR PROPOSALS
                     Agency of Human Services, Department for Children and Families


CRITERIA FOR SCORING                                                                  Total      Applicant
                                                                                      possible   Score
                                                                                      points
1 INFORMATION FROM THE BIDDER

A. Letter of Interest
    Signed letter of interested including a statement of the number of hours
       that you are willing to perform services at the Disability Determination
       Services office each week. You do not have to specify days and
       timeframes; however, your availability should be no less than 8 hours per
       week to be performed generally between the hours of 6:00 AM and 6:00
       PM, Monday through Friday.
    Updated Curriculum Vitae including
            ♦ General Background
            ♦ Education (general/specialized)
            ♦ Medical or Psychological Training (e.g. internships, residencies,
                 fellowships)
            ♦ Clinical Experience
            ♦ Other Professional Experience (e.g. academic appointments,
                 industrial/organizational consultant)
            ♦ Research and Studies Experience (programs related to disability)
            ♦ Disability Claims Review Experience (government and/or
                 private industry)
            ♦ Required Training in Specialty
            ♦ Description of Computer Competence/Experience
    Copy of current license to practice medicine, osteopathy, or doctoral-
       level psychology in Vermont.
    List of at least three professional references with a signed, dated
       statement giving the Vermont Disability Determination Services
       permission to contact these references. If you have worked for another
       State Disability Determination Services or for Social Security or a private
       disability program, please include references from these organizations.
2 TECHNICAL PROPOSAL/PROGRAM SPECIFICATIONS

A. Bidder’s Experience                                                                90
DISABILITY PROGRAM EXPERIENCE                                                         25
Disability program experience is defined as the review of disability claims or case
files and the interpretation of regulations and policies as a medical or
psychological specialist in a disability claims program. All experience in a
disability claims program, both public and private, will be considered; references
will be contacted for information about quality of performance.
NOTE: The performance of consultative examinations is not considered “disability
experience” as defined above. Similarly, the preparation of reports of treatment on
behalf of disability claimants is not considered "disability program experience".
CLINICAL EXPERIENCE                                                                   25
Since Disability Determination medical consultants are involved in reviewing
evidence submitted by practicing physicians and medical specialists, it is
required that the contractor have had clinical experience treating patients.
Evidence must include dates, places, responsibilities and other relevant
information. NOTE: The greatest number of points will be given for the most recent
pertinent clinical experience.

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                              SIMPLIFIED REQUEST FOR PROPOSALS
                    Agency of Human Services, Department for Children and Families
INTERDISCIPLINARY TEAM EXPERIENCE                                                      20
Work of the Disability Determination medical consultant involves engaging
with other physicians and medical specialists, lay adjudicators, and Disability
Determination supervisory and policy staff in developing a well-documented
claim record and a well-supported, programmatically defensible eligibility
determination. The clinical aspects of each case must be synthesized with the
legal guidelines of the program, making each team player equally important to
the quality of the team‟s product. Candidates should describe in detail all
interdisciplinary team experience, including the positions of team-members,
the nature of team interactions, and outcomes of the team‟s work together.
MEDICAL TEACHING EXPERIENCE                                                            20
Work of the Disability Determination medical consultant involves advising
other physicians, medical specialists, and policy staff. It also includes teaching
classes of new lay adjudicators and mentoring adjudicators throughout their
professional development. Instructional experience in interpreting and
transmitting information on medical matters is important. Candidates should
describe all experience doing medical teaching to medical and non-medical
audiences, including titles (i.e., instructor, associate professor, professor, etc.)
and the dates of teaching. Nature of students being instructed (e.g., other
physicians, medical students, nurses, social workers, laypersons, etc.) should
also be included.
B. Bidder’s Qualifications/Skills                                                      30
DEMONSTRATED COMPUTER SKILLS                                                           15
Disability Determination medical consultants must use a computer to review
claims electronically, to code and complete electronic forms, to type narrative
analyses of claims, to read and answer e-mail messages, and to research and
read internet medical and Social Security policy resources. To receive credit,
candidates must describe past experience using computers, including any
experience with electronic files, internet resources, email, data entry, word
processing, or navigating using Microsoft Windows.
WRITING SKILLS                                                                         15
The work of the Disability Determination medical consultant requires a
persuasive narrative analysis of each case for various audiences, including lay
adjudicators, program administrators, other Disability Determination and
Social Security doctors, claimants and their representatives. Candidates should
describe any research projects and/or studies, any published material or
unpublished research and/or studies in a medical specialty, and any other
experience that exemplifies the individual‟s writing skills. Dates, topics, length
and places of publication will be considered to demonstrate the quality of the
writing.
OVERALL TOTAL SCORE                                                                    120




11 STATE AND AGENCY CUSTOMARY CONTRACTING PROVSIONS:




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                      SIMPLIFIED REQUEST FOR PROPOSALS
               Agency of Human Services, Department for Children and Families
                               ATTACHMENT C
                CUSTOMARY PROVISIONS FOR CONTRACTS AND GRANTS


1. Entire Agreement. This Agreement, whether in the form of a Contract, State Funded Grant, or
   Federally Funded Grant, represents the entire agreement between the parties on the subject
   matter. All prior agreements, representations, statements, negotiations, and understandings shall
   have no effect.
2. Applicable Law. This Agreement will be governed by the laws of the State of Vermont.
3. Definitions: For purposes of this Attachment, “Party” shall mean the Contractor, Grantee or
   Subrecipient, with whom the State of Vermont is executing this Agreement and consistent with the
   form of the Agreement.
4. Appropriations: If appropriations are insufficient to support this Agreement, the State may
   cancel on a date agreed to by the parties or upon the expiration or reduction of existing
   appropriation authority. In the case that this Agreement is funded in whole or in part by federal or
   other non-State funds, and in the event those funds become unavailable or reduced, the State may
   suspend or cancel this Agreement immediately, and the State shall have no obligation to fund this
   Agreement from State revenues.
5. No Employee Benefits For Party: The Party understands that the State will not provide any
   individual retirement benefits, group life insurance, group health and dental insurance, vacation
   or sick leave, workers compensation or other benefits or services available to State employees, nor
   will the state withhold any state or federal taxes except as required under applicable tax laws,
   which shall be determined in advance of execution of the Agreement. The Party understands that
   all tax returns required by the Internal Revenue Code and the State of Vermont, including but not
   limited to income, withholding, sales and use, and rooms and meals, must be filed by the Party,
   and information as to Agreement income will be provided by the State of Vermont to the Internal
   Revenue Service and the Vermont Department of Taxes.
6. Independence, Liability: The Party will act in an independent capacity and not as officers or
   employees of the State.
   The Party shall defend the State and its officers and employees against all claims or suits arising in
   whole or in part from any act or omission of the Party or of any agent of the Party. The State shall
   notify the Party in the event of any such claim or suit, and the Party shall immediately retain
   counsel and otherwise provide a complete defense against the entire claim or suit. The Party shall
   notify its insurance company and the State within 10 days of receiving any claim for damages,
   notice of claims, pre-claims, or service of judgments or claims, for any act or omissions in the
   performance of this Agreement.

   After a final judgment or settlement the Party may request recoupment of specific defense costs
   and may file suit in Washington Superior Court requesting recoupment. The Party shall be
   entitled to recoup costs only upon a showing that such costs were entirely unrelated to the defense
   of any claim arising from an act or omission of the Party.
   The Party shall indemnify the State and its officers and employees in the event that the State, its
   officers or employees become legally obligated to pay any damages or losses arising from any act
   or omission of the Party.
                                              Page 8 of 21
                       SIMPLIFIED REQUEST FOR PROPOSALS
                Agency of Human Services, Department for Children and Families


7. Insurance: Before commencing work on this Agreement the Party must provide certificates of
   insurance to show that the following minimum coverage is in effect. It is the responsibility of the
   Party to maintain current certificates of insurance on file with the state through the term of the
   Agreement. No warranty is made that the coverage and limits listed herein are adequate to cover
   and protect the interests of the Party for the Party’s operations. These are solely minimums that
   have been established to protect the interests of the State.
      Workers Compensation: With respect to all operations performed, the Party shall carry
      workers’ compensation insurance in accordance with the laws of the State of Vermont.
      General Liability and Property Damage: With respect to all operations performed
      under the Agreement, the Party shall carry general liability insurance having all major
      divisions of coverage including, but not limited to:
      Premises - Operations
      Products and Completed Operations
      Personal Injury Liability
      Contractual Liability
   The policy shall be on an occurrence form and limits shall not be less than:
      $1,000,000 Per Occurrence
      $1,000,000 General Aggregate
      $1,000,000 Products/Completed Operations Aggregate
      $ 50,000 Fire/ Legal/Liability
   Party shall name the State of Vermont and its officers and employees as additional insureds for
   liability arising out of this Agreement.
      Automotive Liability: The Party shall carry automotive liability insurance covering all
      motor vehicles, including hired and non-owned coverage, used in connection with the
      Agreement. Limits of coverage shall not be less than: $1,000,000 combined single limit.
   Party shall name the State of Vermont and its officers and employees as additional insureds for
   liability arising out of this Agreement.
       Professional Liability: Before commencing work on this Agreement and throughout the
       term of this Agreement, the Party shall procure and maintain professional liability insurance
       for any and all services performed under this Agreement, with minimum coverage of $____
       _______ per occurrence, and $____ _______ aggregate.


8. Reliance by the State on Representations: All payments by the State under this Agreement
   will be made in reliance upon the accuracy of all prior representations by the Party, including but
   not limited to bills, invoices, progress reports and other proofs of work.




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                           SIMPLIFIED REQUEST FOR PROPOSALS
                  Agency of Human Services, Department for Children and Families


9. Requirement to Have a Single Audit: In the case that this Agreement is a Grant that is funded
   in whole or in part by federal funds, and if this Subrecipient expends $500,000 or more in federal
   assistance during its fiscal year, the Subrecipient is required to have a single audit conducted in
   accordance with the Single Audit Act, except when it elects to have a program specific audit.
   The Subrecipient may elect to have a program specific audit if it expends funds under only one federal program and the
   federal program’s laws, regulating or grant agreements do not require a financial statement audit of the Party.
   A Subrecipient is exempt if the Party expends less than $500,000 in total federal assistance in one year.
   The Subrecipient will complete the Certification of Audit Requirement annually within 45 days after its fiscal year end. If
   a single audit is required, the sub-recipient will submit a copy of the audit report to the primary pass-through Party and
   any other pass-through Party that requests it within 9 months. If a single audit is not required, the Subrecipient will
   submit the Schedule of Federal Expenditures within 45 days. These forms will be mailed to the Subrecipient by the
   Department of Finance and Management near the end of its fiscal year. These forms are also available on the Finance &
   Management Web page at: http://finance.vermont.gov/forms

10. Records Available for Audit: The Party will maintain all books, documents, payroll papers,
   accounting records and other evidence pertaining to costs incurred under this agreement and
   make them available at reasonable times during the period of the Agreement and for three years
   thereafter for inspection by any authorized representatives of the State or Federal Government. If
   any litigation, claim, or audit is started before the expiration of the three year period, the records
   shall be retained until all litigation, claims or audit findings involving the records have been
   resolved. The State, by any authorized representative, shall have the right at all reasonable times
   to inspect or otherwise evaluate the work performed or being performed under this Agreement.
11. Fair Employment Practices and Americans with Disabilities Act: Party agrees to
   comply with the requirement of Title 21V.S.A. Chapter 5, Subchapter 6, relating to fair
   employment practices, to the full extent applicable. Party shall also ensure, to the full extent
   required by the Americans with Disabilities Act of 1990, as amended, that qualified individuals
   with disabilities receive equitable access to the services, programs, and activities provided by the
   Party under this Agreement. Party further agrees to include this provision in all subcontracts.
12. Set Off: The State may set off any sums which the Party owes the State against any sums due the
   Party under this Agreement; provided, however, that any set off of amounts due the State of
   Vermont as taxes shall be in accordance with the procedures more specifically provided
   hereinafter.




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                         SIMPLIFIED REQUEST FOR PROPOSALS
                  Agency of Human Services, Department for Children and Families


13. Taxes Due to the State:
         a. Party understands and acknowledges responsibility, if applicable, for compliance with State
            tax laws, including income tax withholding for employees performing services within the
            State, payment of use tax on property used within the State, corporate and/or personal
            income tax on income earned within the State.
         b. Party certifies under the pains and penalties of perjury that, as of the date the Agreement is
            signed, the Party is in good standing with respect to, or in full compliance with, a plan to
            pay any and all taxes due the State of Vermont.
         c. Party understands that final payment under this Agreement may be withheld if the
            Commissioner of Taxes determines that the Party is not in good standing with respect to or
            in full compliance with a plan to pay any and all taxes due to the State of Vermont.
       Party also understands the State may set off taxes (and related penalties, interest and fees) due
       to the State of Vermont, but only if the Party has failed to make an appeal within the time
       allowed by law, or an appeal has been taken and finally determined and the Party has no further
       legal recourse to contest the amounts due.
14.      Child Support: (Applicable if the Party is a natural person, not a corporation or partnership.)
      Party states that, as of the date the Agreement is signed, he/she:
         a. is not under any obligation to pay child support; or
         b. is under such an obligation and is in good standing with respect to that obligation; or
         c. has agreed to a payment plan with the Vermont Office of Child Support Services and is in
            full compliance with that plan.
       Party makes this statement with regard to support owed to any and all children residing in
       Vermont. In addition, if the Party is a resident of Vermont, Party makes this statement with
       regard to support owed to any and all children residing in any other state or territory of the
       United States.
15. Sub-Agreements: Party shall not assign, subcontract or subgrant the performance of his
   Agreement or any portion thereof to any other Party without the prior written approval of the
   State. Party also agrees to include in subcontract or subgrant agreements a tax certification in
   accordance with paragraph 13 above.
      Notwithstanding the foregoing, the State agrees that the Party may assign this agreement,
      including all of the Party's rights and obligations hereunder, to any successor in interest to the
      Party arising out of the sale of or reorganization of the Party.


16. No Gifts or Gratuities: Party shall not give title or possession of any thing of substantial value
   (including property, currency, travel and/or education programs) to any officer or employee of the
   State during the term of this Agreement.
17. Copies: All written reports prepared under this Agreement will be printed using both sides of
   the paper.


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                                  SIMPLIFIED REQUEST FOR PROPOSALS
                     Agency of Human Services, Department for Children and Families
18. Certification Regarding Debarment: Party certifies under pains and penalties of perjury
   that, as of the date that this Agreement is signed, neither Party nor Party’s principals (officers,
   directors, owners, or partners) are presently debarred, suspended, proposed for debarment,
   declared ineligible or excluded from participation in federal programs or programs supported in
   whole or in part by federal funds.
State of Vermont – Attachment C
Revised AHS – 1-11-11




                                              Page 12 of 21
                          SIMPLIFIED REQUEST FOR PROPOSALS
                  Agency of Human Services, Department for Children and Families
                                           ATTACHMENT E
                                   BUSINESS ASSOCIATE AGREEMENT
This Business Associate Agreement (“Agreement”) is entered into by and between the State of Vermont Agency
of Human Services operating by and through its Department, Office, or Division of (________Insert
Department, Office, or Division) (“Covered Entity”) and (________Insert Name of the Contractor)
(“Business Associate”) as of (________Insert Date) (“Effective Date”). This Agreement supplements and is made
a part of the Contract to which it is an attachment.
Covered Entity and Business Associate enter into this Agreement to comply with standards promulgated under the
Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) including the Standards for the Privacy of
Individually Identifiable Health Information at 45 CFR Parts 160 and 164 (“Privacy Rule”) and the Security
Standards at 45 CFR Parts 160 and 164 (“Security Rule”), as amended by subtitle D of the Health Information
Technology for Economic and Clinical Health Act.
The parties agree as follows:
1.   Definitions. All capitalized terms in this Agreement have the meanings identified in this Agreement, 45 CFR
     Part 160, or 45 CFR Part 164.
     The term “Services” includes all work performed by the Business Associate for or on behalf of Covered Entity
     that requires the use and/or disclosure of protected health information to perform a business associate
     function described in 45 CFR 160.103 under the definition of Business Associate.
     The term “Individual” includes a person who qualifies as a personal representative in accordance with 45 CFR
     164.502(g).
     The term “Breach” means the acquisition, access, use or disclosure of protected health information (PHI) in a
     manner not permitted under the HIPAA Privacy Rule, 45 CFR part 164, subpart E, which compromises the
     security or privacy of the PHI. “Compromises the security or privacy of the PHI” means poses a significant
     risk of financial, reputational or other harm to the individual.
2.   Permitted and Required Uses/Disclosures of PHI.
     2.1   Except as limited in this Agreement, Business Associate may use or disclose PHI to perform Services, as
           specified in the underlying contract with Covered Entity. Business Associate shall not use or disclose
           PHI in any manner that would constitute a violation of the Privacy Rule if used or disclosed by Covered
           Entity in that manner. Business Associate may not use or disclose PHI other than as permitted or
           required by this Agreement or as Required by Law.
     2.2   Business Associate may make PHI available to its employees who need access to perform Services
           provided that Business Associate makes such employees aware of the use and disclosure restrictions in
           this Agreement and binds them to comply with such restrictions. Business Associate may only disclose
           PHI for the purposes authorized by this Agreement: (a) to its agents (including subcontractors) in
           accordance with Sections 8 and 16 or (b) as otherwise permitted by Section 3.
3.   Business Activities. Business Associate may use PHI received in its capacity as a “Business Associate” to
     Covered Entity if necessary for Business Associate‟s proper management and administration or to carry out its
     legal responsibilities. Business Associate may disclose PHI received in its capacity as “Business Associate” to
     Covered Entity for Business Associate‟s proper management and administration or to carry out its legal
     responsibilities if a disclosure is Required by Law or if (a) Business Associate obtains reasonable written
     assurances via a written agreement from the person to whom the information is to be disclosed that the PHI
     shall remain confidential and be used or further disclosed only as Required by Law or for the purpose for
     which it was disclosed to the person and (b) the person notifies Business Associate, within three business days
     (who in turn will notify Covered Entity within three business days after receiving notice of a Breach as

                                                  Page 13 of 21
                          SIMPLIFIED REQUEST FOR PROPOSALS
                   Agency of Human Services, Department for Children and Families
     specified in Section 5.1), in writing of any Breach of Unsecured PHI of which it is aware. Uses and disclosures
     of PHI for the purposes identified in this Section must be of the minimum amount of PHI necessary to
     accomplish such purposes.
4.   Safeguards. Business Associate shall implement and use appropriate safeguards to prevent the use or
     disclosure of PHI other than as provided for by this Agreement. With respect to any PHI that is maintained in
     or transmitted by electronic media, Business Associate shall comply with 45 CFR sections 164.308
     (administrative safeguards), 164.310 (physical safeguards), 164.312 (technical safeguards) and 164.316 (policies
     and procedures and documentation requirements). Business Associate shall identify in writing upon request
     from Covered Entity all of the safeguards that it uses to prevent impermissible uses or disclosures of PHI.
5.   Documenting and Reporting Breaches.
     5.1 Business Associate shall report to Covered Entity any Breach of Unsecured PHI as soon as it (or any of its
         employees or agents) become aware of any such Breach, and in no case later than three (3) business days
         after it (or any of its employees or agents) becomes aware of the Breach, except when a law enforcement
         official determines that a notification would impede a criminal investigation or cause damage to national
         security.
     5.2 Business Associate shall provide Covered Entity with the names of the individuals whose Unsecured PHI
         has been, or is reasonably believed to have been, the subject of the Breach and any other available
         information that is required to be given to the affected individuals, as set forth in 45 CFR §164.404(c),
         and, if requested by Covered Entity, information necessary for Covered Entity to investigate the
         impermissible use or disclosure. Business Associate shall continue to provide to Covered Entity
         information concerning the Breach as it becomes available to it.
     5.3   When Business Associate determines that an impermissible acquisition, use or disclosure of PHI by a
           member of its workforce does not pose a significant risk of harm to the affected individuals, it shall
           document its assessment of risk. Such assessment shall include: 1) the name of the person(s) making the
           assessment, 2) a brief summary of the facts, and 3) a brief statement of the reasons supporting the
           determination of low risk of harm. When requested by Covered Entity, Business Associate shall make its
           risk assessments available to Covered Entity.
6. Mitigation and Corrective Action. Business Associate shall mitigate, to the extent practicable, any harmful
   effect that is known to it of an impermissible use or disclosure of PHI, even if the impermissible use or
   disclosure does not constitute a Breach. Business Associate shall draft and carry out a plan of corrective action
   to address any incident of impermissible use or disclosure of PHI. If requested by Covered Entity, Business
   Associate shall make its mitigation and corrective action plans available to Covered Entity.
7.   Providing Notice of Breaches.
     7.1 If Covered Entity determines that an impermissible acquisition, access, use or disclosure of PHI for which
          one of Business Associate‟s employees or agents was responsible constitutes a Breach as defined in 45
          CFR §164.402, and if requested by Covered Entity, Business Associate shall provide notice to the
          individuals whose PHI was the subject of the Breach. When requested to provide notice, Business
          Associate shall consult with Covered Entity about the timeliness, content and method of notice, and shall
          receive Covered Entity‟s approval concerning these elements. The cost of notice and related remedies
          shall be borne by Business Associate.
     7.2 The notice to affected individuals shall be provided as soon as reasonably possible and in no case later than
          60 calendar days after Business Associate reported the Breach to Covered Entity.
     7.3   The notice to affected individuals shall be written in plain language and shall include, to the extent
           possible, 1) a brief description of what happened, 2) a description of the types of Unsecured PHI that
           were involved in the Breach, 3) any steps individuals can take to protect themselves from potential harm
                                                    Page 14 of 21
                           SIMPLIFIED REQUEST FOR PROPOSALS
                   Agency of Human Services, Department for Children and Families
           resulting from the Breach, 4) a brief description of what the Business associate is doing to investigate the
           Breach, to mitigate harm to individuals and to protect against further Breaches, and 5) contact procedures
           for individuals to ask questions or obtain additional information, as set forth in 45 CFR §164.404(c).
     7.4   Business Associate shall notify individuals of Breaches as specified in 45 CFR §164.404(d) (methods of
           individual notice). In addition, when a Breach involves more than 500 residents of Vermont, Business
           associate shall, if requested by Covered Entity, notify prominent media outlets serving Vermont, following
           the requirements set forth in 45 CFR §164.406.


8.   Agreements by Third Parties. Business Associate shall ensure that any agent (including a subcontractor) to
     whom it provides PHI received from Covered Entity or created or received by Business Associate on behalf of
     Covered Entity agrees in a written agreement to the same restrictions and conditions that apply through this
     Agreement to Business Associate with respect to such PHI. For example, the written contract must include
     those restrictions and conditions set forth in Section 14. Business Associate must enter into the written
     agreement before any use or disclosure of PHI by such agent. The written agreement must identify Covered
     Entity as a direct and intended third party beneficiary with the right to enforce any breach of the agreement
     concerning the use or disclosure of PHI. Business Associate shall provide a copy of the written agreement to
     Covered Entity upon request. Business Associate may not make any disclosure of PHI to any agent without
     the prior written consent of Covered Entity.
9.   Access to PHI. Business Associate shall provide access to PHI in a Designated Record Set to Covered Entity
     or as directed by Covered Entity to an Individual to meet the requirements under 45 CFR 164.524. Business
     Associate shall provide such access in the time and manner reasonably designated by Covered Entity. Within
     three (3) business days, Business Associate shall forward to Covered Entity for handling any request for access
     to PHI that Business Associate directly receives from an Individual.
10. Amendment of PHI. Business Associate shall make any amendments to PHI in a Designated Record Set that
    Covered Entity directs or agrees to pursuant to 45 CFR 164.526, whether at the request of Covered Entity or
    an Individual. Business Associate shall make such amendments in the time and manner reasonably designated
    by Covered Entity. Within three (3) business days, Business Associate shall forward to Covered Entity for
    handling any request for amendment to PHI that Business Associate directly receives from an Individual.
11. Accounting of Disclosures. Business Associate shall document disclosures of PHI and all information related
    to such disclosures as would be required for Covered Entity to respond to a request by an Individual for an
    accounting of disclosures of PHI in accordance with 45 CFR 164.528. Business Associate shall provide such
    information to Covered Entity or as directed by Covered Entity to an Individual, to permit Covered Entity to
    respond to an accounting request. Business Associate shall provide such information in the time and manner
    reasonably designated by Covered Entity. Within three (3) business days, Business Associate shall forward to
    Covered Entity for handling any accounting request that Business Associate directly receives from an Individual.
12. Books and Records. Subject to the attorney-client and other applicable legal privileges, Business Associate
    shall make its internal practices, books, and records (including policies and procedures and PHI) relating to the
    use and disclosure of PHI received from Covered Entity or created or received by Business Associate on
    behalf of Covered Entity available to the Secretary in the time and manner designated by the Secretary.
    Business Associate shall make the same information available to Covered Entity (without regard to the
    attorney-client or other applicable legal privileges) upon Covered Entity‟s request in the time and manner
    reasonably designated by Covered Entity so that Covered Entity may determine whether Business Associate is
    in compliance with this Agreement.
13. Termination.


                                                    Page 15 of 21
                         SIMPLIFIED REQUEST FOR PROPOSALS
                  Agency of Human Services, Department for Children and Families
    13.1 This Agreement commences on the Effective Date and shall remain in effect until terminated by
         Covered Entity or until all of the PHI provided by Covered Entity to Business Associate or created or
         received by Business Associate on behalf of Covered Entity is destroyed or returned to Covered Entity
         subject to Section 17.7.
    13.2 If Business Associate breaches any material term of this Agreement, Covered Entity may either: (a)
         provide an opportunity for Business Associate to cure the breach and Covered Entity may terminate this
         Contract without liability or penalty if Business Associate does not cure the breach within the time
         specified by Covered Entity; or (b) immediately terminate this Contract without liability or penalty if
         Covered Entity believes that cure is not reasonably possible; or (c) if neither termination nor cure are
         feasible, Covered Entity shall report the breach to the Secretary. Covered Entity has the right to seek to
         cure any breach by Business Associate and this right, regardless of whether Covered Entity cures such
         breach, does not lessen any right or remedy available to Covered Entity at law, in equity, or under this
         Contract, nor does it lessen Business Associate‟s responsibility for such breach or its duty to cure such
         breach.
14. Return/Destruction of PHI.
    14.1 Business Associate in connection with the expiration or termination of this Contract shall return or
         destroy, at the discretion of the Covered Entity, all PHI received from Covered Entity or created or
         received by Business Associate on behalf of Covered Entity pursuant to this Contract that Business
         Associate still maintains in any form or medium (including electronic) within thirty (30) days after such
         expiration or termination. Business Associate shall not retain any copies of the PHI. Business Associate
         shall certify in writing for Covered Entity (1) when all PHI has been returned or destroyed and (2) that
         Business Associate does not continue to maintain any PHI. Business Associate is to provide this
         certification during this thirty (30) day period.
    14.2 Business Associate shall provide to Covered Entity notification of any conditions that Business
         Associate believes make the return or destruction of PHI infeasible. If Covered Entity agrees that
         return or destruction is infeasible, Business Associate shall extend the protections of this Agreement to
         such PHI and limit further uses and disclosures of such PHI to those purposes that make the return or
         destruction infeasible for so long as Business Associate maintains such PHI.
15. Penalties and Training. Business Associate understands that: (a) there may be civil or criminal penalties for
    misuse or misappropriation of PHI and (b) violations of this Agreement may result in notification by Covered
    Entity to law enforcement officials and regulatory, accreditation, and licensure organizations. If requested by
    Covered Entity, Business Associate shall participate in training regarding the use, confidentiality, and security
    of PHI.
16. Security Rule Obligations. The following provisions of this Section apply to the extent that Business
    Associate creates, receives, maintains or transmits Electronic PHI on behalf of Covered Entity.
    16.1 Business Associate shall implement and use administrative, physical, and technical safeguards in
         compliance with 45 CFR sections 164.308, 164.310, and 164.312 with respect to the Electronic PHI that
         it creates, receives, maintains or transmits on behalf of Covered Entity. Business Associate shall identify
         in writing upon request from Covered Entity all of the safeguards that it uses to protect such Electronic
         PHI.
    16.2 Business Associate shall ensure that any agent (including a subcontractor) to whom it provides
         Electronic PHI agrees in a written agreement to implement and use administrative, physical, and
         technical safeguards that reasonably and appropriately protect the Confidentiality, Integrity and
         Availability of the Electronic PHI. Business Associate must enter into this written agreement before any
         use or disclosure of Electronic PHI by such agent. The written agreement must identify Covered Entity
         as a direct and intended third party beneficiary with the right to enforce any breach of the agreement
                                                Page 16 of 21
                        SIMPLIFIED REQUEST FOR PROPOSALS
                 Agency of Human Services, Department for Children and Families
          concerning the use or disclosure of Electronic PHI. Business Associate shall provide a copy of the
          written agreement to Covered Entity upon request. Business Associate may not make any disclosure of
          Electronic PHI to any agent without the prior written consent of Covered Entity.
    16.3 Business Associate shall report in writing to Covered Entity any Security Incident pertaining to such
         Electronic PHI (whether involving Business Associate or an agent, including a subcontractor). Business
         Associate shall provide this written report as soon as it becomes aware of any such Security Incident,
         and in no case later than three (3) business days after it becomes aware of the incident. Business
         Associate shall provide Covered Entity with the information necessary for Covered Entity to investigate
         any such Security Incident.
    16.4 Business Associate shall comply with any reasonable policies and procedures Covered Entity
         implements to obtain compliance under the Security Rule.
17. Miscellaneous.
   17.1   In the event of any conflict or inconsistency between the terms of this Agreement and the terms of the
          Contract, the terms of this Agreement shall govern with respect to its subject matter. Otherwise the
          terms of the Contract continue in effect.
    17.2 Business Associate shall cooperate with Covered Entity to amend this Agreement from time to time as
         is necessary for Covered Entity to comply with the Privacy Rule, the Security Rule, or any other
         standards promulgated under HIPAA.
    17.3 Any ambiguity in this Agreement shall be resolved to permit Covered Entity to comply with the Privacy
         Rule, Security Rule, or any other standards promulgated under HIPAA.
    17.4 In addition to applicable Vermont law, the parties shall rely on applicable federal law (e.g., HIPAA, the
         Privacy Rule and Security Rule) in construing the meaning and effect of this Agreement.
    17.5 As between Business Associate and Covered Entity, Covered Entity owns all PHI provided by Covered
         Entity to Business Associate or created or received by Business Associate on behalf of Covered Entity.
    17.6 Business Associate shall abide by the terms and conditions of this Agreement with respect to all PHI it
         receives from Covered Entity or creates or receives on behalf of Covered Entity under this Contract
         even if some of that information relates to specific services for which Business Associate may not be a
         “Business Associate” of Covered Entity under the Privacy Rule.
    17.7 The provisions of this Agreement that by their terms encompass continuing rights or responsibilities
         shall survive the expiration or termination of this Agreement. For example: (a) the provisions of this
         Agreement shall continue to apply if Covered Entity determines that it would be infeasible for Business
         Associate to return or destroy PHI as provided in Section 14.2 and (b) the obligation of Business
         Associate to provide an accounting of disclosures as set forth in Section 11 survives the expiration or
         termination of this Agreement with respect to accounting requests, if any, made after such expiration or
         termination.


(AHS Rev: 8/31/10)




                                                  Page 17 of 21
                         SIMPLIFIED REQUEST FOR PROPOSALS
                  Agency of Human Services, Department for Children and Families
                                 ATTACHMENT F
             AGENCY OF HUMAN SERVICES’ CUSTOMARY CONTRACT PROVISIONS


1. Agency of Human Services – Field Services Directors will share oversight with the department (or field
   office) that is a party to the contract for provider performance using outcomes, processes, terms and conditions
   agreed to under this contract.


2. 2-1-1 Data Base: The Contractor providing a health or human services within Vermont, or near the border that
   is readily accessible to residents of Vermont, will provide relevant descriptive information regarding its agency,
   programs and/or contact and will adhere to the "Inclusion/Exclusion" policy of Vermont's United
   Way/Vermont 211. If included, the Contractor will provide accurate and up to date information to their data
   base as needed. The “Inclusion/Exclusion” policy can be found at www.vermont211.org
3. Medicaid Program Contractors:
   Inspection of Records: Any contracts accessing payments for services through the Global Commitment to
   Health Waiver and Vermont Medicaid program must fulfill state and federal legal requirements to enable the
   Agency of Human Services (AHS), the United States Department of Health and Human Services (DHHS) and
   the Government Accounting Office (GAO) to:
       Evaluate through inspection or other means the quality, appropriateness, and timeliness of services
       performed; and Inspect and audit any financial records of such Contractor or subcontractor.
   Subcontracting for Medicaid Services: Having a subcontract does not terminate the Contractor, receiving funds
   under Vermont‟s Medicaid program, from its responsibility to ensure that all activities under this agreement are
   carried out. Subcontracts must specify the activities and reporting responsibilities of the Contractor or
   subcontractor and provide for revoking delegation or imposing other sanctions if the Contractor or
   subcontractor‟s performance is inadequate. The Contractor agrees to make available upon request to the
   Agency of Human Services; the Department of Vermont Health Access; the Department of Disabilities, Aging
   and Independent Living; and the Center for Medicare and Medicaid Services (CMS) all contracts and
   subcontracts between the Contractor and service providers.
   Medicaid Notification of Termination Requirements: Any Contractor accessing payments for services under the
   Global Commitment to Health Waiver and Medicaid programs who terminates their practice will follow the
   Department of Vermont Health Access, Managed Care Organization enrollee notification requirements.
   Encounter Data: Any Contractor accessing payments for services through the Global Commitment to Health
   Waiver and Vermont Medicaid programs must provide encounter data to the Agency of Human Services
   and/or its departments and ensure that it can be linked to enrollee eligibility files maintained by the State.
   Federal Medicaid System Security Requirements Compliance: All contractors and subcontractors must provide a
   security plan, risk assessment, and security controls review document within three months of the start date of
   this agreement (and update it annually thereafter) to support audit compliance with 45CFR95.621 subpart F,
   ADP (Automated Data Processing) System Security Requirements and Review Process.


4. Non-discrimination Based on National Origin as evidenced by Limited English Proficiency. The
   Contractor agrees to comply with the non-discrimination requirements of Title VI of the Civil Rights Act of
   1964, 42 USC Section 2000d, et seq., and with the federal guidelines promulgated pursuant to Executive Order
   13166 of 2000, which require that contractors and subcontractors receiving federal funds must assure that
   persons with limited English proficiency can meaningfully access services. To the extent the Contractor

                                                   Page 18 of 21
                          SIMPLIFIED REQUEST FOR PROPOSALS
                  Agency of Human Services, Department for Children and Families
   provides assistance to individuals with limited English proficiency through the use of oral or written translation
   or interpretive services in compliance with this requirement, such individuals cannot be required to pay for such
   services.
5. Voter Registration. When designated by the Secretary of State, the Contractor agrees to become a voter
   registration agency as defined by 17 V.S.A. §2103 (41), and to comply with the requirements of state and federal
   law pertaining to such agencies.


6. Drug Free Workplace Act. The Contractor will assure a drug-free workplace in accordance with 45 CFR Part
   76.
7. Privacy and Security Standards.
   Protected Health Information: The Contractor shall maintain the privacy and security of all individually
   identifiable health information acquired by or provided to it as a part of the performance of this contract. The
   Contractor shall follow federal and state law relating to privacy and security of individually identifiable health
   information as applicable, including the Health Insurance Portability and Accountability Act (HIPAA) and its
   federal regulations.
   Substance Abuse Treatment Information: The confidentiality of any alcohol and drug abuse treatment
   information acquired by or provided to the Contractor or subcontractor shall be maintained in compliance with
   any applicable state or federal laws or regulations and specifically set out in 42 CFR Part 2.
   Other Confidential Consumer Information: The Contractor agrees to comply with the requirements of AHS
   Rule No. 08-048 concerning access to information. The Contractor agrees to comply with any applicable
   Vermont State Statute, including but not limited to 12 VSA §1612 and any applicable Board of Health
   confidentiality regulations. The Contractor shall ensure that all of its employees and subcontractors performing
   services under this agreement understand the sensitive nature of the information that they may have access to
   and sign an affirmation of understanding regarding the information‟s confidential and non-public nature.
   Social Security numbers: The Contractor agrees to comply with all applicable Vermont State Statutes to assure
   protection and security of personal information, including protection from identity theft as outlined in Title 9,
   Vermont Statutes Annotated, Ch. 62.


8. Abuse Registry. The Contractor agrees not to employ any individual, use any volunteer, or otherwise provide
   reimbursement to any individual in the performance of services connected with this agreement, who provides care,
   custody, treatment, transportation, or supervision to children or vulnerable adults if there is a substantiation of
   abuse or neglect or exploitation against that individual. The Contractor will check the Adult Abuse Registry in the
   Department of Disabilities, Aging and Independent Living. Unless the Contractor holds a valid child care license or
   registration from the Division of Child Development, Department for Children and Families, the Contractor shall
   also check the Central Child Protection Registry. (See 33 V.S.A. §4919(a)(3) & 33 V.S.A. §6911(c)(3)).


9. Reporting of Abuse, Neglect, or Exploitation. Consistent with provisions of 33 V.S.A. §4913(a) and §6903,
   any agent or employee of a Contractor who, in the performance of services connected with this agreement, has
   contact with clients or is a caregiver and who has reasonable cause to believe that a child or vulnerable adult has
   been abused or neglected as defined in Chapter 49 or abused, neglected, or exploited as defined in Chapter 69
   of Title 33 V.S.A. shall make a report involving children to the Commissioner of the Department for Children
   and Families within 24 hours or a report involving vulnerable adults to the Division of Licensing and Protection
   at the Department of Disabilities, Aging, and Independent Living within 48 hours. This requirement applies
   except in those instances where particular roles and functions are exempt from reporting under state and federal
                                                   Page 19 of 21
                          SIMPLIFIED REQUEST FOR PROPOSALS
                  Agency of Human Services, Department for Children and Families
   law. Reports involving children shall contain the information required by 33 V.S.A. §4914. Reports involving
   vulnerable adults shall contain the information required by 33 V.S.A. §6904. The Contractor will ensure that its
   agents or employees receive training on the reporting of abuse or neglect to children and abuse, neglect or
   exploitation of vulnerable adults.


10. Intellectual Property/Work Product Ownership. All data, technical information, materials first gathered,
    originated, developed, prepared, or obtained as a condition of this agreement and used in the performance of
    this agreement - including, but not limited to all reports, surveys, plans, charts, literature, brochures, mailings,
    recordings (video or audio), pictures, drawings, analyses, graphic representations, software computer programs
    and accompanying documentation and printouts, notes and memoranda, written procedures and documents,
    which are prepared for or obtained specifically for this agreement - or are a result of the services required under
    this grant - shall be considered "work for hire" and remain the property of the State of Vermont, regardless of
    the state of completion - unless otherwise specified in this agreement. Such items shall be delivered to the State
    of Vermont upon 30 days notice by the State. With respect to software computer programs and / or source
    codes first developed for the State, all the work shall be considered "work for hire,” i.e., the State, not the
    Contractor or subcontractor, shall have full and complete ownership of all software computer programs,
    documentation and/or source codes developed.
   The Contractor shall not sell or copyright a work product or item produced under this agreement without
   explicit permission from the State.
   If the Contractor is operating a system or application on behalf of the State of Vermont, then the Contractor
   shall not make information entered into the system or application available for uses by any other party than the
   State of Vermont, without prior authorization by the State. Nothing herein shall entitle the State to pre-existing
   Contractor‟s materials.


11. Security and Data Transfers. The State shall work with the Contractor to ensure compliance with all
    applicable State and Agency of Human Services' policies and standards, especially those related to privacy and
    security. The State will advise the Contractor of any new policies, procedures, or protocols developed during the
    term of this agreement as they are issued and will work with the Contractor to implement any required.
   The Contractor will ensure the physical and data security associated with computer equipment - including
   desktops, notebooks, and other portable devices - used in connection with this agreement. The Contractor will
   also assure that any media or mechanism used to store or transfer data to or from the State includes industry
   standard security mechanisms such as continually up-to-date malware protection and encryption. The
   Contractor will make every reasonable effort to ensure media or data files transferred to the State are virus and
   spyware free. At the conclusion of this agreement and after successful delivery of the data to the State, the
   Contractor shall securely delete data (including archival backups) from the Contractor's equipment that contains
   individually identifiable records, in accordance with standards adopted by the Agency of Human Services.


12. Computing and Communication: The Contractor shall select, in consultation with the Agency of Human
    Services‟ Information Technology unit, one of the approved methods for secure access to the State‟s systems
    and data, if required. Approved methods are based on the type of work performed by the Contractor as part of
    this agreement. Options include, but are not limited to:
   1. Contractor‟s provision of certified computing equipment, peripherals and mobile devices, on a separate
      Contractor‟s network with separate internet access. The Agency of Human Services‟ accounts may or may
      not be provided.

                                                    Page 20 of 21
                          SIMPLIFIED REQUEST FOR PROPOSALS
                  Agency of Human Services, Department for Children and Families
   2. State supplied and managed equipment and accounts to access state applications and data, including State
      issued active directory accounts and application specific accounts, which follow the National Institutes of
      Standards and Technology (NIST) security and the Health Insurance Portability & Accountability Act
      (HIPAA) standards.
   The State will not supply e-mail accounts to the Contractor.


13. Lobbying. No federal funds under this agreement may be used to influence or attempt to influence an officer
    or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a
    member of Congress in connection with the awarding of any federal contract, continuation, renewal,
    amendments other than federal appropriated funds.


14. Non–discrimination. The Contractor will prohibit discrimination on the basis of age under the Age
    Discrimination Act of 1975, on the basis of handicap under section 504 of the Rehabilitation Act of 1973, on
    the basis of sex under Title IX of the Education Amendments of 1972, or on the basis of race, color or national
    origin under Title VI of the Civil Rights Act of 1964. No person shall on the grounds of sex (including, in the
    case of a woman, on the grounds that the woman is pregnant) or on the grounds of religion, be excluded from
    participation in, be denied the benefits of, or be subjected to discrimination, to include sexual harassment, under
    any program or activity supported by state and/or federal funds.
   The Contractor will also not refuse, withhold from or deny to any person the benefit of services, facilities,
   goods, privileges, advantages, or benefits of public accommodation on the basis of disability, race, creed, color,
   national origin, marital status, sex, sexual orientation or gender identity under Title 9 V.S.A. Chapter 139.


15. Environmental Tobacco Smoke. Public Law 103-227, also known as the Pro-children Act of 1994 (Act),
    requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for
    by an entity and used routinely or regularly for the provision of health, child care, early childhood development
    services, education or library services to children under the age of 18, if the services are funded by federal
    programs either directly or through state or local governments, by federal grant, contract, loan or loan
    guarantee. The law also applies to children's services that are provided in indoor facilities that are constructed,
    operated, or maintained with such Federal funds.
   The law does not apply to children's services provided in private residences; portions of facilities used for
   inpatient drug or alcohol treatment; service providers whose sole source of applicable federal funds is Medicare
   or Medicaid; or facilities where Women, Infants, & Children (WIC) coupons are redeemed.
   Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up
   to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible
   entity.
   Contractors are prohibited from promoting the use of tobacco products for all clients. Facilities supported by
   state and federal funds are prohibited from making tobacco products available to minors.


   Attachment F - Revised AHS -12/10/10




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